PSYCHIATRIC HISTORY TAKINGSTARTING THE INTERVIEW * Make every attempt to build rappo e patient. The doctor-patient relationship must be base autual respect a jer to optimally help the patient.A hostile or an authoritarian attitude may complicate the relationship, compromise tru: nd put unnecessary obstacles in the of helping * Always start with self-introduction (name and occupation), aim of the interview, ensure privacy and confidentiality and if possible, choose the m m te juct the interview. The patient must be consulted on the presence of others, including family membe they may hinder the p f history taking Pra ening and make sure to take notes. Only rec if the patient givePSYCHIATRIC HISTORY COMPARED TO OTHER BRANCHES OF MEDICINE * Psychiatry is one ranches of medicine that mostly lacks confirmatory lab or radiologic nost disorders and rather depends mainly on good dt nveyed by the history taking, c © psychiatrist's judgment and understanding non-verbal careful history taking gives valuable insight into the possible diagnoses, and thus accurat treatment . of medicine, psychiatry places special focus on social and and the role of the surrounding environment (i.e.: Family, ips on the patient's current psychological, emotionalSome patients my require additional aid during history t For deaf/mute patients we may communicate with the patient in written form, or, i possible, use sign language with the aid of (non-family) certified interpreters. If neither is je, we may condu e interview with a person whom the patient lives with/info * Form the legal age) and p ellectual ardian is ired, but we may inter aterview, especially if there is susp: of ° ry taking should be postponed if the patient under the influence of a psychoactive substance (e.g.:A may take part tory from the family/inform the patient iCOMPONENTS OF THE PSYCHIATRIC HISTORYIDENTIFYING Dy Patien| Vienna af asldine ‘ha patbacil : atie bias ememt is/her Ve. a din the If y informants, we 1 ment dissociative a NM, atient f ich 6 “ ae aire iff has is/t nay SC eIDENTIFYING DAI fem are level of g 2 1 \ tary pe 2 f Marit and caretak d child J rel r ti al fu ing, po informar p nden >, single and wid le may be pror , 2 D | i [IDENTIFYING.Pyle AN em PatraCHIEF COMPLAINTHISTORY OF PRESENT ILLNESS * It is preferable to use open-ended questions to allow the patient to express him/herself more clearly and provide more information about his/her condition Close-ended (yes/no) questions limit the amount of information gained in the interview, however, they may be used to clarify or gather further details about the symptoms or the pat t's responses to open-ended questions. They may also be used if the patient is being difficult/un >perative What brings you here today?”,““How can | help you today?” and “What seems to be the problem?” are examples of open-ended questions * After the initial que stion, we should ask a few f low-up questions (and use open ended questions as much as possible.) Ask the patient, if possible, to compare between his current situation and the last time he/she felt “well” (i.e.: Baseline functioning)HISTORY OF PRESENT ILLNESS toms if the patient i providing enough y ask about their sleep pattern, appetite, m: cidality and homicidality, unusual perceptu i atel 4 was your ood in th x! onthHISTORY OF PRESENT ILLNESS Follow The h | appr F ulne lit ir hara rait I. F ors (family problems (high er i illne ice at Pe r dit ill ii abt 1 loy financial ot Pr i 7 P vi ily, adequate treatmenteo) tel NMA SN)PAST PSYCHIATRIC HISTORY 3. prescribed and how comp! 4. Substan abuse/misuse: (A may alter the Ask about the s the amount ns in the patient u substances (e.g.: Only after being expose 2D the nce in a hazard situation such d and rout tion. We may include the CAGE questionnaire for alcohol use if alcohol uPAST PSYCHIATRIC HISTORYPAST MEDICAL AND SURGICAL HISTORY * We should ask about the patient's previous medi 9ses, surgical procedure traumas, hospital ad: sions and medications pr The significance of asking t the medical surgical history Medical problems, especially those of a chronic nature, may be precipitating factor f the mental health problem presented. They may also be worsened by s ne psychotropi 2. Some medical problems (such as thyroid diseases), head traumas and CNS diseases (such as epilepsy) have psychiatric manifestations 3. If the patient receives medications on a regular basis, drug-drug interactions are possible if used with ce tropics. 4. Pregnancy and lactat to ask about in women of child-bearing age they may affect the treFAMILY HISTORYauRWwN SOCIALAND DEVELOPMENTAL HISTORY We should ask the patient about their persona social and developme understand the patient's past and baseline functioning better, improve rapport and c diagnosis | history to obtain a more accurat Ask about the following Whom was the patient brought up by? How was the family environment? Where did he/she grow up? The How was his/her relationship with his/her family? His/her friends and colleagues? OCI economic status of the family he/she grew up in If the patient stopped education earlier than expected, ask why. Did he/she have any problems in school? Ask about school phobia, bullying, truancy and academic performance If the patient pursued higher education ask about any related issues and his/her demic performance in coll e/university.SOCIAL AND D